Hal Johnson, MPH Florida Substance Abuse Program Office and the

1. Alcohol use and binge drinking among Hispanic/Latino subculture youth, and the differences in the affect of acculturation Hal Johnson, MPH Florida Substance Abuse Program Office and the FSU Florida Center for Prevention Research June 4, 2012 Council of State and Territorial Epidemiologists Omaha, Nebraska

2. Background • Risky behaviors vary among different races/ethnicities • Hispanic ethnicity is a growing portion of the US population • Many programs/interventions have been developed to reduce risky behaviors, including underage drinking, among Hispanic youth.

3. Background • However, most of these programs don’t distinguish between Hispanic subcultures • Spanish, Mexican, Puerto Rican, Central American and other Hispanic cultures, while sharing some aspects, are different • Examining differences between these subcultures in the US is challenging for several reasons

4. Background • Challenges • Immigration patterns - limited diversity of Hispanic subcultures in most areas • Underage drinking – limited age range means limited population • Few databases include information on ethnicity at a level lower than “Hispanic”

5. Florida Youth Substance Abuse Survey • Annually since 2000 • Even years – County level (~60,000) • Odd years – State level (~8,000) • Grades 6 through 12 • Based on Communities That Care Survey

6. Florida Youth Substance Abuse Survey How do you describe yourself? (You can choose one answer, or more than one) • American Indian/Native American or Alaska Native • Asian • Black/African American • Spanish/Hispanic/Latino • Native Hawaiian or other Pacific Islander • White/Caucasian • Other

7. Florida Youth Substance Abuse Survey Which one of these ethnic groups BEST describes you? (Choose only one answer) • Central American (Guatemalan, Nicaraguan, Honduran, for example) • Cuban or Cuban American • Dominican • Mexican or Mexican American • Puerto Rican • Other Hispanic, Latino or Spanish origin • Haitian • West Indian or Caribbean • None of these

8. Florida Youth Substance Abuse Survey • Consistent differences by race/ethnicity • Whites use at the highest rate • Black youth use at lowest rate • Hispanic youth use at a slightly lower rate than non-Hispanic Whites • Similar results from other school based surveys such as Monitoring the Future

9. Florida Youth Substance Abuse Survey

10. Florida Youth Substance Abuse Survey

11. Hispanic Youth Population Trend * Source: Florida Office of Economic and Demographic Research (Age 10-17)

12. Florida youth Ethnicity (FYSAS)

13. Hispanic Subcultures among Florida youth (FYSAS)

14. Data Considerations • Use even year data • Exclude 2000 • Changes made in race/ethnic variables • Compare each year for variations • Combine years • Weight to adjust for sample size

15. Population Proportion Across Years

16. Combined Dataset Ethnicities

17. Past-30-day Alcohol Use

18. Binge Drinking

19. Odds Ratios Reference Group: Non-Hispanic White Control Variables: Age Gender Mother’s education Father’s education

20. Acculturation “Acculturation … is now commonly viewed as a multidimensional process in which one maintains aspects of their culture of origin while also adopting elements of the new cultural group.” Coatsworth and Maldonado-Molina. J Community Psychol. 2005. 33(2).

21. Acculturation • Acculturation has been implicated as a risk factor for substance use and other unhealthy behaviors • 1990 to 2000 Hispanic Population Growth* • 50% increase in # American-born Hispanics • 81% increase in # born in other countries • In 2000, 40% of all Hispanics and 54% of southern US Hispanics were foreign born* *Saenz, R. www2.asanet.org/public/saenz_brief.ppt

22. Acculturation • Length of time in the US related to less acculturation • Language spoken at home is reasonable proxy for length of time in US and acculturation • FYSAS has one question on language spoken at home

23. Acculturation FYSAS question: What is the language you use most often at home? • English • Spanish • Another Language

24. Language Spoken at Home

25. Past-30-day Use and Binge Drinking by Language Spoken at Home – All Hispanic Youth

26. Odds Ratios – Language Spoken at Home OR Group: Speak Spanish at Home Reference Group: Speak English at Home Control Variables: Age Gender Mother’s education Father’s education

27. Past-30-Day Alcohol Use by Language Spoken at Home

28. Binge Drinking by Language Spoken at Home

29. Odds Ratios – Language Spoken at Home OR Group: Speak Spanish at Home Reference Group: Speak English at Home Control Variables: Age Gender Mother’s education Father’s education

30. Summary • All Hispanic youth in Florida drink and binge drink at a rate between NH-Whites and NH-Blacks • But there are differences among the Hispanic subcultures • Central American youth less likely to drink or binge than others • “Other Hispanic” youth more likely to drink or binge than others • Mexican youth more likely to binge than others

31. Summary • Hispanics speaking Spanish at home less likely to report past-30-day use, but not binge drinking • Subculture differences: • Cuban, Mexican and Puerto Rican youth show past-30-day acculturation affect • Central American and Mexican youth show binge drinking acculturation affect • No other significant differences

32. Conclusions • FYSAS provides an excellent opportunity to investigate AOD use and other risky behavior among Hispanic subpopulations • Large and growing Hispanic youth population • More diverse Hispanic population than most states • Annual youth survey with large N and useful ethnicity and acculturation questions

33. Conclusions • Hispanic youth are not homogeneous • There are differences in alcohol use and binge drinking among subcultures • There are differences in the affect of acculturation on likelihood to drink or binge drink • Taking subculture into account can add to the effectiveness of targeted prevention programs